Availability of assisted peritoneal dialysis in Europe: call for increased and equal access

Author:

Brown Edwina A1ORCID,Ekstrand Agneta2,Gallieni Maurizio34,Gorrín Maite Rivera5,Gudmundsdottir Helga6,Guedes Anabela Malho7ORCID,Heidempergher Marco4,Kitsche Benno89,Lobbedez Thierry10ORCID,Lundström Ulrika Hahn11ORCID,McCarthy Kate12,Mellotte George J13ORCID,Moranne Olivier14ORCID,Petras Dimitrios15,Povlsen Johan V16,Punzalan Sally1,Wiesholzer Martin17

Affiliation:

1. Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust , London , UK

2. Abdomen Centre, Nephrology, Helsinki University Hospital , Helsinki , Finland

3. Department of Biomedical and Clinical Sciences, Università di Milano , Milan , Italy

4. Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco , Milano , Italy

5. Servicio de Nefrología, Hospital Ramón y Cajal , Madrid , Spain

6. Department of Nephrology, Oslo University Hospital, Ulleval , Oslo , Norway

7. Serviço de Nefrologia, Centro Hospitalar Universitário do Algarve , Faro , Portugal

8. Kuratorium für Dialyse und Nierentransplantation e.V. , Cologne , Germany

9. NADia—Netzwerk assistierte Dialyse , Berlin , Germany

10. Néphrologie, CHU CAEN, Normandy , France

11. Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm , Sweden

12. Baxter Healthcare Ltd, Wallingford, Compton , Newbury , UK

13. Trinity Health Kidney Centre, Tallaght University Hospital, Tallaght , Dublin , Ireland

14. Department of Nephrology-Dialysis-Apheresis, CHU Caremeau Nimes , Nimes , France

15. Department of Nephrology, General Hospital ‘Hippokration’ , Athens , Greece

16. Department of Renal Medicine, Aarhus University Hospital , Aarhus , Denmark

17. Clinical Department for Internal Medicine, University Hospital St Poelten, Karl Landsteiner University of Health Sciences , St Poelten , Austria

Abstract

ABSTRACT Background Availability of assisted PD (asPD) increases access to dialysis at home, particularly for the increasing numbers of older and frail people with advanced kidney disease. Although asPD has been widely used in some European countries for many years, it remains unavailable or poorly utilized in others. A group of leading European nephrologists have therefore formed a group to drive increased availability of asPD in Europe and in their own countries. Methods Members of the group filled in a proforma with the following headings: personal experience, country experience, who are the assistants, funding of asPD, barriers to growth, what is needed to grow and their top three priorities. Results Only 5 of the 13 countries surveyed provided publicly funded reimbursement for asPD. The use of asPD depends on overall attitudes to PD, with all respondents mentioning the need for nephrology team education and/or patient education and involvement in dialysis modality decision making. Conclusions and call to action Many people with advanced kidney disease would prefer to have their dialysis at home, yet if the frail patient chooses PD most healthcare systems cannot provide their choice. AsPD should be available in all countries in Europe and in all renal centres. The top priorities to make this happen are education of renal healthcare teams about the advantages of PD, education of and discussion with patients and their families as they approach the need for dialysis, and engagement with policymakers and healthcare providers to develop and support assistance for PD.

Funder

Baxter Healthcare Corporation

National Institute for Health Research

Biomedical Research Centre

Karl Landsteiner Society

Institute for Nephrology

Publisher

Oxford University Press (OUP)

Subject

Transplantation,Nephrology

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